Daily Dose: Most Long COVID Outcomes Resolve in 1 Year After Mild Infection

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On January 17, 2023, we reported on a study published in BMJ that aimed to determine the clinical sequelae of long COVID for 1 year after infection in patients with mild disease and to evaluate its association with age, sex, SARS-CoV-2 variants, and vaccination status.

The study

Researchers tapped electronic health records from the nationwide database of Maccabi Healthcare Services, the second-largest health maintenance organization in Israel, comprising nearly 2 million citizens. Complete data were available for 299 855 individuals (median age 25 years, half women), who tested positive for COVID-19 between March 1, 2020, and Oct 1, 2021, and had not been hospitalized within a month of their diagnosis.

Overall investigators found that the following COVID-19 outcomes were significantly associated with both the early (30-180 days) and late (180-360 days) time periods after infection: anosmia and dysgeusia; cognitive impairment; dyspnea; weakness; and palpitations. Risk for hair loss, chest pain, cough, myalgia, and respiratory disorders were significantly increased during the early period of mild COVID-19 infection but not in the later period. Men and women showed minor differences, and children had fewer outcomes than adults during the early phase of COVID-19, which mostly resolved in the late period. Findings remained consistent across SARS-CoV-2 variants.

Clinical implications

“Although the long covid phenomenon has been feared and discussed since the beginning of the pandemic, we observed that most health outcomes arising after a mild disease course remained for several months and returned to normal within the first year. This nationwide dataset of patients with mild covid-19 suggests that mild disease does not lead to serious or chronic long term morbidity in the vast majority of patients and adds a small continuous burden on healthcare providers. Importantly, the risk for lingering dyspnoea was reduced in vaccinated patients with breakthrough infection compared with unvaccinated people, while risks of all other outcomes were comparable.”

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